E.V. SKLYANNAYA

1. Gorky Donetsk National Medical University, 16 prospekt Illyicha, Donetsk, Ukraine, 283092

  Sklyannaya E.V. — Cand. Med. Sc., Associate Professor of the Hospital Therapy Department, tel. (38062) 341-43-65, e-mail: elena_skl1979@mail.ru

Arterial hypertension (AH) is one of the most widespread non-infectious diseases in the world. Sympathetic nervous system plays a great role in AH pathogenesis, especially in young people. The aim of this study was to evaluate the prognostic value of heart rate variability as a risk factor of arterial hypertension in young adults. Material and methods. The prospective observational study was performed with 918 young adults of 20—29 y. o. and normal level of blood pressure (BP). Heart rate variability was assessed using “Kadiotekhnika 04-3R” system (Inkart, Russia). Statistical time and spectral parameters were determined. The time statistical parameters include: SDNN (standard deviation of the NN interval), rMSSD (square root of the mean squared differences of successive NN interval), pNN50 % (number of pairs of adjacent NN intervals differing by more than 50 ms count divided by the total number of all NN intervals). The spectral parameters included: TP (total power of the spectre at the range of 0.003—0.40 Hz), HF (power of high frequency oscillations at the range of 0.15–0.4 Hz), LF (power in low frequency at the range of 0.04–0.15 Hz), HFn and LFn (HF and LF in normalised units), VLF (power of very low frequency oscillations at the range of 0.003—0.04 Hz), LF/HF (sympatho-vagal index). Observation period was 5 years. Two groups were assigned according to AH level: 1 group — with normal arterial pressure level (lower than 140/90 mm Hg), 2 group — with high arterial pressure (140/90 mm Hg and higher).

Results. During the observation period, 78 person were withdrawn from the study for different reasons. Normal arterial pressure was found in 620 participants (81.2 %, 95 % CI 78.3—83.8 %) — 1^st group; АH was found in 144 people (18.8 %, 95 % CI 16.2—21.7 %) — 2^nd group. Sympatho-vagal index was higher in the 2^nd group then in the 1^st group (5.0±1.95 versus 1.99±0.62 respectively, р<0.001). By the results of univariate analysis,  the following were significant risk factors of AH: male gender (OR 10.8, 95 % CI 7.63—15.28), body mass index (BMI) >25 kg/m² (OR 7.17, 95 % CI 5.65—9.10), smoking (OR 5.61, 95 % CI 4.5—6.98), high normal BP (OR 10.68, 95 % CI 6.92—14.51) and LF/HF>3.0(OR 8.0, 95 % CI 6.21—10.29). The multivariate analysis indicated the following significant risk factors of AH: BMI >25 kg/m², smoking and LF/HF>3.0.

Conclusions. Expressed sympathotony (LF/HF>3.0) is an independent risk factor of AH during the next 5 years in the young adults with initially normal level of arterial pressure.

Key words: arterial hypertension, heart rate variability, sympatho-vagal index, prediction.

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